The treatment of complex parapneumonic effusions in children remains controversial, with some advocating less invasive, strictly medical management and others supporting a more aggressive approach of thoracotomy with or without decortication. Recent advances, including video-assisted thoracoscopic surgery and intrapleural fibrinolytic therapy, offer new options for effective treatment. We repor...

Percutaneous catheter drainage is a standard therapy for management of selected intra-abdominal abscesses. We describe three patients in whom this technique caused complicated thoracic empyemas. All patients required thoracotomy for decortication despite initial thoracostomy tube drainage. In each case, the percutaneously placed drainage catheter was found traversing the costophrenic angle, lea...

Nirschl release appears to be a very successful technique for surgically suitable cases of tennis elbow. However, although the drilling or decortication aspect of the procedure was thought to be of benefit to the immediate outcome, this has not actually been confirmed. This randomised double blind comparative prospective trial shows that drilling confers no benefit and actually causes more pain...